HPV stands for Human Papilloma Virus (papilloma = fancy name for warts), and includes a group of over 150 related viruses. Each type has a number (because who wants to name that many viruses?), and some of those types are responsible for the development of cancer. Cancer caused by HPV can affect the cervix, vulva, vagina, penis, or anus in the genital region and may result in throat, tongue or tonsilar cancer orally. Other symptoms of HPV infection include genital warts, which usually manifest as painless bumps in the genital region, although size and whether flat or raised can vary from one infection to another.
HPV infections are very common. In fact, nearly all men and women will get at least one form of HPV infection at some point in their lives. 79 million Americans are currently infected, with about 14 million new cases developing each year. That being said, most infections never result in any symptoms, and 9 of 10 cases typically resolve on their own within a couple of years. The problems occur with the other 1 in 10 HPV cases, which are persistent and cause over 30,000 cases of cancer each year.
HPV infections can be transmitted via intimate contact, whether vaginal, anal, or oral intercourse, and this transmission can occur even in the absence of symptoms. At this time, there haven’t been any documented cases of infection from toilet seats, but HPV may be transmitted through shared toys used during sexual activity.
Fortunately, prevention of the strains that are most commonly responsible for cancer are possible. The CDC recommends HPV vaccination with the 2 dose course starting at age 11-12 for both boys and girls. If starting the series from age 15-26, then 3 doses are recommended. This vaccination has been very effective with clinical trials that suggested close to 100% protection against cervical precancers and genital warts, and there has been a 64% reduction in vaccine-type HPV infections since the vaccine was introduced in 2006. The safety of this vaccine has also been excellent with the most common side effects being pain or redness at the injection site, fever, headache, nausea or joint pain.
Still, whether vaccinated or not, cervical cancer screening is recommended for all women from age 21-65. These ages may vary slightly depending on a woman’s medical history, but general guidelines are as follows in women with no history of abnormal pap smear: from age 21-29, pap smears are advised every 3 years, and from age 30-65, pap smears and/or HPV testing are suggested every 3-5 years depending on the type of testing that is done. What’s the difference, you ask? Pap smears are checking for abnormal cells whereas HPV testing checks for evidence of HPV infection, the virus that may cause abnormal cells. For younger women in the 21-29 age group, HPV infections are so common and so often cleared by the woman’s immune system, that HPV testing is not often suggested in order to minimize excess biopsies. Even though cervical testing may not have to happen every year, breast and pelvic exams (to check for uterine or ovarian enlargement) are typically advised on a yearly basis as is the chance for STD testing if needed. And of course, mammograms, cholesterol testing, blood pressure checks, etc. should still be done regularly at the advised ages as well. Sorry, you still have to check in once a year in most cases :)
Remember that pap smears and HPV testing are both screening tests only. That means that positive results often need to be evaluated further in order to determine the severity of the infection, and even though screening isn’t absolutely perfect, testing catches most of the abnormalities when used correctly. Checking in regularly for your screening helps decrease the chance of missed infection as well. If you have any of the following risk factors such as multiple sexual partners, intercourse beginning at a young age, weakened immune system, smoking, or history of other sexually-transmitted infection, be sure to let your provider know as you may require more frequent evaluation. Abnormal cervical cells can often be managed before they become cervical cancer, so if you’ve fallen behind on your screening, take a moment to schedule your well-woman visit so you can help take charge of your health :)
Dr. Nick
HPV infections are very common. In fact, nearly all men and women will get at least one form of HPV infection at some point in their lives. 79 million Americans are currently infected, with about 14 million new cases developing each year. That being said, most infections never result in any symptoms, and 9 of 10 cases typically resolve on their own within a couple of years. The problems occur with the other 1 in 10 HPV cases, which are persistent and cause over 30,000 cases of cancer each year.
HPV infections can be transmitted via intimate contact, whether vaginal, anal, or oral intercourse, and this transmission can occur even in the absence of symptoms. At this time, there haven’t been any documented cases of infection from toilet seats, but HPV may be transmitted through shared toys used during sexual activity.
Fortunately, prevention of the strains that are most commonly responsible for cancer are possible. The CDC recommends HPV vaccination with the 2 dose course starting at age 11-12 for both boys and girls. If starting the series from age 15-26, then 3 doses are recommended. This vaccination has been very effective with clinical trials that suggested close to 100% protection against cervical precancers and genital warts, and there has been a 64% reduction in vaccine-type HPV infections since the vaccine was introduced in 2006. The safety of this vaccine has also been excellent with the most common side effects being pain or redness at the injection site, fever, headache, nausea or joint pain.
Still, whether vaccinated or not, cervical cancer screening is recommended for all women from age 21-65. These ages may vary slightly depending on a woman’s medical history, but general guidelines are as follows in women with no history of abnormal pap smear: from age 21-29, pap smears are advised every 3 years, and from age 30-65, pap smears and/or HPV testing are suggested every 3-5 years depending on the type of testing that is done. What’s the difference, you ask? Pap smears are checking for abnormal cells whereas HPV testing checks for evidence of HPV infection, the virus that may cause abnormal cells. For younger women in the 21-29 age group, HPV infections are so common and so often cleared by the woman’s immune system, that HPV testing is not often suggested in order to minimize excess biopsies. Even though cervical testing may not have to happen every year, breast and pelvic exams (to check for uterine or ovarian enlargement) are typically advised on a yearly basis as is the chance for STD testing if needed. And of course, mammograms, cholesterol testing, blood pressure checks, etc. should still be done regularly at the advised ages as well. Sorry, you still have to check in once a year in most cases :)
Remember that pap smears and HPV testing are both screening tests only. That means that positive results often need to be evaluated further in order to determine the severity of the infection, and even though screening isn’t absolutely perfect, testing catches most of the abnormalities when used correctly. Checking in regularly for your screening helps decrease the chance of missed infection as well. If you have any of the following risk factors such as multiple sexual partners, intercourse beginning at a young age, weakened immune system, smoking, or history of other sexually-transmitted infection, be sure to let your provider know as you may require more frequent evaluation. Abnormal cervical cells can often be managed before they become cervical cancer, so if you’ve fallen behind on your screening, take a moment to schedule your well-woman visit so you can help take charge of your health :)
Dr. Nick
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